W. K. EVANS, M.D.; R. FELD, M.D.; N. MURRAY, M.D.; A. WILLAN, Ph.D., M.D.; D. OSOBA, M.D.; F. A. SHEPHERD, M.D.; D. A. CLARK, M.D., Ph.D.; M. LEVITT, M.Sc., M.D.; A. MacDONALD, M.D.; K. WILSON, M.B.; W. SHELLEY, M.D.; J. PATER, M.Sc
The National Cancer Institute of Canada Clinical Trials Group conducted a prospective randomized study comparing standard chemotherapy with alternating chemotherapy in patients with extensive small cell lung cancer. "Standard" treatment consisted of cyclophosphamide (1000 mg/m2 body surface area); doxorubicin (50 mg/m2), and vincristine (2 mg) every 3 weeks for six courses. Alternating chemotherapy was cyclophosphamide, doxorubicin, and vincristine alternating with etoposide (100 mg/m2 on days 1 to 3) and cisplatin (25 mg/m2 on days 1 to 3) every 3 weeks for six treatment cycles. Two hundred eighty-nine patients were eligible and evaluable for response to therapy and survival. Best response was higher in patients on alternating chemotherapy (complete plus partial response, 80% compared with 63.2%p < 0.002). Progression-free survival for patients on alternating chemotherapy was superior (p < 0.0001) as was overall survival (p = 0.03). Major toxicities were equally frequent in both treatment groups. These results show a modest superiority of alternating chemotherapy over standard therapy in extensive small cell lung cancer.
EVANS WK, FELD R, MURRAY N, WILLAN A, OSOBA D, SHEPHERD FA, et al. Superiority of Alternating Non-Cross-Resistant Chemotherapy in Extensive Small Cell Lung Cancer: A Multicenter, Randomized Clinical Trial by the National Cancer Institute of Canada. Ann Intern Med. ;107:451–458. doi: 10.7326/0003-4819-107-4-451
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Published: Ann Intern Med. 1987;107(4):451-458.
Hematology/Oncology, Lung Cancer, Pulmonary/Critical Care.
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